Single transitions and persistence of unemployment are associated with poor health outcomes

Abstract

Background Although job loss has been associated with decline in health, the effect of long term unemployment is less clear and under-researched. Furthermore, the impact of an economic recession on this relationship is unclear. We investigated the associations of single transitions and persistence of unemployment with health. We subsequently examined whether these associations are affected by the latest recession, which began in 2008. Methods In total, 57,911 participants from the Dutch Health Interview Survey who belonged to the labour force between 2004 and 2014 were included. Based on longitudinal tax registration data, single employment transitions between time point 1 (t1) and time point 2 (t2) and persistent unemployment (i.e. number of years individuals were unemployed) between t1 and time point 5 (t5) were defined. General and mental health, smoking and obesity were assessed at respectively time point 3 (t3) and time point 6 (t6). Logistic regression models were performed and interactions with recession indicators (year, annual gross domestic product estimates and regional unemployment rates) were tested. Results Compared with individuals who stayed employed at t1 and t2, the likelihood of poor mental health at the subsequent year was significantly higher in those who became unemployed at t2. Persistent unemployment was associated with poor mental health, especially for those who were persistently unemployed for 5 years. Similar patterns, although less pronounced for smoking, were found for general health and obesity. Indicators of the economic recession did not modify these associations. Conclusions Single transitions into unemployment and persistent unemployment are associated with poor mental and general health, obesity, and to a lesser extend smoking. Our study suggests that re-employment might be an important strategy to improve health of unemployed individuals. The relatively extensive Dutch social security system may explain that the economic recession did not modify these associations.

Long-Term Effects of the Individual Placement and Support Intervention on Employment Status: 6-Year Follow-Up of a Randomized Controlled Trial

“…More recent evidence supports the assumption that employment benefits prevail for people with and without mental illness (8)(9)(10)(11). Conversely, the negative effects of unemployment may be particularly profound for people with mental illness (12,13).…”

An Assessment of the Social Determinants of Health in an Urban Emergency Department

“…2. Sociodemographic characteristics of patients visiting the emergency department based on their social determinants of health (SDOH) stratum (based on SDOH index score: lower impact stratum -index score 0-5; middle impact stratum -index score 6-10; and higher impact stratum -Index score [11][12][13][14][15][16].…”

“…Studies have shown that there is a higher prevalence of poor health and mortality in the unemployed. [11][12][13] In homeless individuals, lack of resources makes it difficult to maintain health and navigate the health system, and makes them more likely to use the ED than the general population. [14][15][16][17] Food insecurity, lower education levels, and limited access to primary care have all been found to increase ED utilization as well.…”

The interplay of gender, social context, and long-term unemployment effects on subjective health trajectories

“…Another aspect to consider is short-term as opposed to long-term unemployment, where the latter is largely associated with worse health [3,6,[16][17][18]. While individuals who had experienced repeated unemployment compared to those who had never been unemployed reported significantly worse mental health and lower life satisfaction [19], individuals who had experienced single unemployment compared to the other groups (i.e., repeated unemployment or no experience at all) only significantly differed in their satisfaction with income and employment [20].…”